Urinary System Kidney Structure

kidneys, ureters, bladder & urethra

Capsule
Kidney Function Hilum
Filters blood • ureter → renal pelvis
• removes waste products → major and minor calyxes
• conserves salts, glucose, • renal artery and vein
proteins, nutrients and water → segmental arteries
→ interlobar arteries
Produces urine → arcuate arteries
→ interlobular arteries
Endocrine functions
• regulates blood pressure Medulla
• produces • renal pyramids
• renin • cortical/renal columns
• erythropoietin
• prostaglandins Cortex
• converts vitamin D to active form • renal corpuscles
• cortical labryinth of tubules
• medullary rays

Renal Lobe Renal Lobule Uriniferous Tubule

= renal pyramid & overlying cortex = medullary ray &
surrounding cortical labryinth Nephron + Collecting tubule

Cortex Nephron
Renal corpuscle produces glomerular
ultrafiltrate (180 L per day) from blood

Ultrafiltrate is concentrated
• Proximal tubule
• convoluted
• straight
• Henle’s loop
Medulla • thick descending
• thin
• thick ascending
• Distal tubule
• Collecting tubule
Papilla

Calyx
Urine (1-2 L per day) secreted from
collecting ducts into calyxes

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 Renal Cortex
Renal Cortex

Medullary ray
= collecting tubules

Renal corpuscle
= glomerulus + Bowman’s capsule

Cortical labyrinth
of tubules

Sobotta & Hammersen: Histology

Juxtaglomerular apparatus
Renal Corpuscle • macula densa in distal tubule
• JG cells in afferent arteriole
• extraglomerular mesangial cells

Urinary / Bowman’s
space

parietal
Bowman’s layer
capsule
visceral
layer

Glomerulus
Glomerulus
• fenestrated capillaries
• podocytes
• intraglomerular mesangial cells

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 Renal Corpuscle Intraglomerular Mesangial Cells
• Support capillaries

• Phagocytose basal lamina

Vascular
pole • Vasoconstrict in response to
angiotensin II

Urinary
pole

Sobotta & Hammersen: Histology

• Endothelial cell
• 70-90 nm fenestra restrict proteins > 70kd
Podocytes
• Basal lamina
Urinary Filtration • heparan sulfate is negatively charged
• produced by endothelial cells & podocytes
Membrane • phagocytosed by mesangial cells

• Podocytes
• pedicels 20-40 nm apart
• diaphragm 6 nm thick with 3-5 nm slits
• podocalyxin in glycocalyx is negatively charged
Urinary Membrane

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 Juxtaglomerular Apparatus
Macula densa in distal tubule
• monitor Na+ content and volume in DT
• low Na+:
• stimulates JG cells to secrete renin
• stimulates JG cells to dilate afferent arteriole Proximal tubule
• tall, narrow columnar cells • proximal convoluted tubule
• numerous microvilli • thick descending limb Henle’s loop

JG cells Henle’s loop

• secrete renin into circulation • thin descending & ascending limbs
• renin converts angiotensinogen → angiotensin I
• contain angiotensin converting enzyme (ACE) Distal tubule
• lung is principal site of ACE activity • thick ascending limb Henle’s loop
• ACE converts angiotensin I → II • distal convoluted tubule
• contain angiotensin I & II • macula densa in DCT
• angiotensin II constricts vasculature and stimulates
secretion of aldosterone and ADH
Collecting tubule & duct
Mesangial • primarily in afferent arteriole
cell
• specialized smooth muscle cells
• no basal lamina between JG cells & macula densa
JG cell

Macula Extraglomerular mesangial cells

densa • also known as Polkissen or lacis cells

Proximal Convoluted Tubule Henle’s Loop (thin segments)

• Cuboidal (low to high) cells

• Eosinophilic granular cytoplasm • Squamous cells
• Basal nuclei • slightly thicker than endothelial cells

• Elaborate brush/striated border • Few short microvilli

• Lateral interdigitations • Lateral interdigitations

• Descending limb
• highly permeable to water, salt and urea
• Resorbs 100% protein, amino acids, glucose, • Ascending limb
creatinine, and bicarbonate ions • impermeable to water
• permeable to salt which enters interstitium
• Resorbs 70-80% of Na+, Cl-, and water
• Na+/K+ pumps in basolateral membrane
• Na+ pumped into interstitium
• Cl- and water follow
• Secretes waste products into lumen

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 Distal Tubule
(DCT & thick ascending limb of Henle’s loop)
Renal Medulla
• Low cuboidal cells
• Collecting tubules/ducts
• Clear pale cytoplasm
• Apical nuclei (DCT) • Henle’s loop (thin segments)
• Central nuclei (Henle’s loop) • Capillaries of vasa recta
• Numerous mitochondria
• Absent (or few short) microvilli
• Basal interdigitations
• Numerous zonula occludens

Sobotta & Hammersen: Histology

• Not permeable to water or urea
• Active Na+/K+ pumps (DCT)
• aldosterone stimulates salt resorption
• H+ and K+ transported into lumen
• Active Cl- pumps (Henle’s thick)
• Cl- enters interstitium (Na+ follows)

Gartner & Hiatt: Color Textbook of Histology

Collecting Tubule & Duct Renal Cortex

Proximal tubule Distal Proximal tubule Henle’s loop
• Cuboidal to columnar cells (convoluted) tubule (straight) (thick)

• Clear cytoplasm
• Central nuclei

• Permeable to urea
• In response to ADH, becomes permeable to
water which enter the interstitium Collecting tubule
Sobotta & Hammersen: Histology

5
 Formation of Urine

Countercurrent Multiplier
System
Increasing osmolarity gradient
exists from corticomedullary
junction to deep in medulla
** due to high urea and salt content
deep in medulla

•Descending thin limb of Henle is freely permeable to water and salt

• Due to increasing osmolarity of interstitium: lumenal volume decreases and osmolarity increases
• Ascending (thin and thick) limb of Henle and DCT are not permeable to water
• Lumenal volume does not change
• Urea enters lumen
• Cl- pumped into interstitium (Na+ follows)
→ increases salt deep in medulla
→ ultrafiltrate becomes hypotonic as it ascends
• Without ADH: collecting tubule/duct impermeable to water
• ADH (pars nervosa of pituitary) makes collecting tubule/duct freely permeable to water and urea
→ increases water resorption, decreases urine volume, and increases urine tonicity
→ increases urea content deep in medulla to maintain interstitial osmolarity gradient

Angiotensin II Regulation of Blood Pressure

Angiotensin II Regulation of Blood Pressure

Burns & Cave: Histology & Cell Biology

6
 Additional Regulators of Kidney Function

Atrial Natriuretic Peptide (ANP) Vasa Rectae

• Secreted by atrial cardiac myocytes
• Function
• decreases renin release
• decreases aldosterone release
• blocks resorption salt and water
• decreases blood pressure
• Peritubular capillary system in medulla
• Freely permeable to water and salts
• Counter current exchange system:
equilibrates contents of medullary
interstitium and vasculature

Alcohol
• decreases ADH release

Caffeine
• increases salt resorption in DCT

Vasculature of Kidney
Renal Segmental Interlobar Arcuate Interlobular
artery artery artery artery artery

Afferent glomerular
Urine is excreted through
arteriole • Calyxes and renal pelvis

Cortex Glomerular capillaries • Ureters

Peritubular • Urinary bladder (storage)

Interlobular Stellate capillary Efferent glomerular
vein vein network Cortical arteriole
• Urethra
nephrons
Juxtamedullary
& deep cortical
nephrons

Arcuate vein Vasa rectae

Medulla
Interlobar vein

Renal vein Netter: Atlas of Human Anatomy

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 Ureter Urinary Bladder
• Mucosa - transitional epithelium
• Muscosa - transitional epithelium
• provides osmotic barrier
• Lamina propria
• Lamina propria
• Muscularis – smooth muscle
• Muscularis – smooth muscle
• Inner longitudinal • inner longitudinal
• Middle circular • middle circular
• Outer longitudinal (lower 1/3) Empty (internal urethral sphincter)
• outer longitudinal

Sobotta & Hammersen: Histology

Sobotta & Hammersen: Histology Gartner & Hiatt: Color Textbook of Histology

Urethra

• Mucosa
• varies from transitional to stratified columnar to
pseudostratified columnar to stratified squamous in
different regions

• Lamina propria
• contains glands of Littre
• highly vascularized

• External urethral sphincter of skeletal muscle

• In the male, 3 regions:

• prostatic
• membranous
• penile or spongy